Order Form

100th ANNIVERSARY PLAQUE

Please print this form and send it with your check.
Checks payable to the Enders Family Association, orders mailed to:

Marilyn Henninger
Box 329
Elizabethville, PA 17023

Orders will be filled as received.

Your Name:

Address 1:

Address 2:

City, State, and Zip Code:

Phone Number:

Email Address:

Quantity	Item	Price
	100th Anniversary Plaque 1912-2012	$20.00 ea.
	S & H*:	$5.50 ea.
	TOTAL

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REMOVE THIS PORTION AND KEEP FOR YOUR RECORDS

ENDERS 100TH ANNIVERSARY PLAQUE
Marilyn Henninger, Box 329, Elizabethville, PA 17023
Phone (717) 362-8991, Email Address: marilynmhenninger@gmail.com

DATE	CHECK NUMBER	AMOUNT PAID